Understanding the differences between a Medicare Supplement plan vs a Medicare Advantage plan can be stressful and confusing. Both plan types offer many benefits to choose from, and your individual health circumstances play a huge role in what plan would be best suited for you. Our agents often hear a Medicare Advantage plan referred to as a Medicare Supplement plan and vice versa, so let’s look at some of the basic differences between these two options.
What is a Medicare Supplement plan?
A Medicare Supplement plan, also known as Medigap, is an insurance plan from a private insurance company that is a secondary payer to your original Medicare. The client pays for this insurance policy monthly. The premiums vary based on your age, gender, and whether you’re a tobacco user or not. These premiums can increase each year based on these factors. The client must also pay a separate premium for a part D prescription drug plan.
The Key Differences Between Medicare Supplement vs Medicare Advantage Plans
One of the attractive features of Medicare Supplement insurance is that there are no networks associated with these plans. If your doctor has not opted out of Medicare, then the plan pays the provider regardless of their practice or location. This applies to any Medicare doctor in any state in the United States. So for folks who are residents of one state for 6 months of the year, and may travel or have a second home for the other six months of the year, this may be a plan to consider. You must pay for this plan every month whether you use it or not.
Medicare Advantage plans are provided by some of the same insurance carriers that sell and service Medicare Supplement plans. However, many Medicare Advantage plans in North Carolina have a $0 premium and $0 deductible. The interesting and sometimes confusing thing about Medicare advantage plans is this varies by carrier, by state and by county. Medicare Advantage plans can be thought of as a “pay as you go plan.” More literally a “Copay” as you go plan. While the premiums are $0, the client must pay copays for services as they see their doctors or go to medical facilities. The client is protected by a maximum annual out of pocket in each plan. These plans typically include a Part D prescription plan at no additional charge. The other big draw to these plans is the competitive extra benefits offered by the carriers. So, what you hear on national commercials is true. The plans in our state and counties offer dental, vision, hearing, and over the counter benefits, and sometimes transportation. Part B Giveback is an interesting benefit. Folks that are on Medicare only may have the option to select a plan with a Part B giveback that ranges from $30 to $100 per month in 2023. The amount of will depend on the carrier and county that you live in.
When choosing between Medicare Supplement versus a Medicare Advantage plan, it’s important to remember that both plans are great insurance coverage from the largest and most respected insurance companies in the world. There are many other options to consider and discuss, and we would love the opportunity to assist you. Our team at Elite Senior Insurance can provide you with a complete analysis of a Medicare Supplement versus Medicare Advantage plan, as well as a full scope of Medicare options that match your needs. Prospective clients are offered these services at no cost to them, so contact us today!
